Crisis Management of Hysteroscopic Surgical Complications in the Office Setting

Abstract

Importance: As health care providers are increasingly motivated to perform office procedures, there is marginal training and attention related to crisis management (CM).Objective: We review the CM in office gynecology and illustrate the value of applying the STOP (stop, think, observe, plan) mental framework to acute management of office hysteroscopy complications.Evidence Acquisition: We performed a literature review on crisis management in gynecology.Results: Concepts of team leadership, simulation training, awareness of human error, and panic control are implemented in CM.Conclusions: Health care providers need to be cognizant of the importance of CM for optimizing patient safety and quality improvement and consider its application on office-based procedures.Relevance: Crisis management has become increasingly relevant in the outpatient setting, seeking to better equip physicians with the skills to manage adverse outcomes while performing office-based procedures.Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: At the completion of this article, physicians should be better able to describe the benefits and risks of office hysteroscopy; evaluate CM principles of human error, simulation training, leadership, and panic control; and assess the STOP mental framework for CM.Health care providers are increasingly motivated to convert ambulatory procedures into office procedures. Ambulatory procedures occur in hospital operating rooms or stand-alone surgery centers subject to state regulation, whereas procedures occurring in physician offices are largely unregulated. Both office-based procedures and ambulatory procedures are elective, are low risk, and do not require an overnight stay. Unforeseen surgical and medical complications are inevitable, and a thoughtful approach needs to be formulated. OfficeDr. Bhagavath has disclosed that he is a consultant/adviser to Hologic, Inc and Caldera Medical. The remaining authors, faculty, and staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity.Lippincott CME Institute has identified and resolved all conflicts of interest concerning this educational activity.